Montreal: The American and Russian delegations at the United Nations, along with six others, recently voted against the new Political Declaration on AIDS.

The United States complained about the inclusion of "divisive" political topics "not related to the fight against AIDS." Russia opposed the previous Political Declaration in 2021 on similar grounds, but this represented a seismic change in the American approach to the issue.

As a political scientist studying the diplomacy of HIV/AIDS, I am not surprised by the US but it does alarm me.

Even as it reduced foreign assistance and dismantled USAID, the US had maintained a veneer of support for the global AIDS response.

Breaking consensus on the AIDS declaration clearly signals that American political priorities now completely override their participation.

This decision can only further politicise debates around the HIV-AIDS response and weaken its reach.

An ongoing battle Organising a global response to the epidemic of HIV/AIDS has been a complex endeavour.

When the disease was first detected in the 1980s, it was immediately associated with certain groups, like gay men and intravenous drug users.

Their marginalisation made it a politically controversial disease to tackle.

Activists succeeded in raising the profile of HIV/AIDS in the 1990s, but it often required focusing on more "palatable" victims, such as children.

By the early 2000s, the world was paying attention, and international organisations like the Global Fund and the Joint United Nations Programme on HIV/AIDS (UNAIDS) had been created to co-ordinate efforts.

Billions in funding were allocated by countries around the world to face the threat.

Nevertheless, many obstacles remain, including the politics of naming vulnerable groups.

Russia's position stems from its long-standing promotion of a moral conservative agenda, which views human rights as secondary to traditional cultural and religious values.

Its opposition to the declaration's rights-based language and policies - specifically those targeting populations termed key by UNAIDS (including men who have sex with men, sex workers, people who inject drugs, transgender individuals and prisoners) - must be viewed through this ideological lens.

This development pulls the global AIDS response directly into international culture wars - a dynamic that has unfortunately become standard in these debates.

New hurdles The US stance worsens this situation, coming at a time of crisis for the international response to HIV-AIDS.

Global funding has decreased since 2025.

Major historical donors like France have cut their contributions.....